GPAC guideline: Asthma in adults—recognition, diagnosis, and management

Issue: BCMJ, vol. 58, No. 4, May 2016, Page 222 News

An updated BC guideline from the Guidelines and Protocols Advisory Committee (GPAC), Asthma in Adults, provides recommendations for recognizing, diagnosing, and managing asthma in adults who are 19 years of age or older presenting in a primary care setting. The guideline is available to physicians across British Columbia via and includes a new action plan and flow sheet.

Key recommendations:
•    30% of asthma patients are mis-diagnosed; send all patients for spirometry, where available, to confirm the diagnosis of asthma.
•    Document the history of respiratory symptoms and objective evidence of airflow obstruction (i.e., spirometry) in all patients suspected of or with an asthma diagnosis, even in cases where the diagnosis seems certain.
•    Do not prescribe asthma medications in cases of low clinical urgency and where the patient has no documented objective evidence to support an asthma diagnosis.
•    As many as 90% of asthma patients use their inhalers incorrectly; regularly review a patient’s inhaler technique, especially when there is a poor or nonresponse to treatment.
•    To improve inhaler technique, especially in those with poor coordination, prescribe all patients a spacer when taking their metred dose inhalers (MDI).
•    To optimize self-management, consider sending all patients to an asthma education centre, where available.
•    Complete a written asthma action plan with all patients and reassess this plan with the patient on a regular basis, especially after an exacerbation.

. GPAC guideline: Asthma in adults—recognition, diagnosis, and management. BCMJ, Vol. 58, No. 4, May, 2016, Page(s) 222 - News.

Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.

For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit

BCMJ Guidelines for Authors

Leave a Reply